Reversible encephalopathy associated with tacrolimus in pediatric renal transplants

Neurological complications post transplant have been described with the use of calcineurin inhibitors. Although tacrolimus may be a better immunosuppr essant than cyclosporine, its neurological side effects may be worse. Two c hildren, living-related kidney trans plant recipients, were treated with an tibody induction, mycophenolate mofetil, prednisone, and tacrolimus. Soon a fter transplant, they each developed an encephalopathy, which when visualiz ed by magnetic resonance imaging showed that it affected both white and gre y matter of the brain. Although the encephalopathy was associated with the use of tacrolimus, there was a complete neurological recovery without cessa tion of the drug.